How prepared is Virginia for a bioterrorism attack or a new disease outbreak? In last year's annual report, "Ready or Not?" by the Trust for America's Health and the Robert Wood Johnson Foundation, the state scored a nine out of 10 on indicators for emergency preparedness.

In this year's report, released Tuesday, the two nonprofit groups noted that cuts to federal public emergency health preparedness funds, combined with state cuts, could jeopardize several key programs.

These include chemical testing capabilities; the Cities Readiness Initiative that supports the ability of localities to rapidly distribute and administer vaccines and medications during emergencies; and the loss of epidemiology field officers, Centers for Disease Control and Prevention (CDC) staff who fill gaps at the state and local levels to respond rapidly to outbreaks, such as the H1N1 flu pandemic.

Bob Mauskapf, director of the Office of Emergency Preparedness for the Virginia Department of Health, acknowledges that the 10 percent cut in CDC funding for 2012, a drop of $2 million since 2010, will result in a degradation of resources and the curtailing of some services. However, he is adamant that public safety will not be affected. "The report talks about the potential for these cuts; the hammer hasn't fallen yet," he says.

Virginia's state lab is one of 10 at risk of losing "Level 1" chemical testing capabilities. This would leave the CDC with the only public health lab in the country with full ability to test for chemical terrorism and accidents. Virginia is also among 24 states at risk of losing epidemiology field officers; and Richmond and Virginia Beach are among 51 cities of the 72 nationwide in the Cities Readiness Initiative at risk for elimination.

Mauskapf credits Virginia with having been forward-looking in planning for cuts and making incremental adjustments over the past four years. "We've established a much more robust infrastructure of epidemiologists and trained personnel," he says.

Other states, he notes, are dealing with more drastic cuts. He adds, "We're coming up with imaginative solutions to do more with less. I'm not concerned about the impact on public safety. We feel very confident that we're up to the challenge."